CAJ | 학술논문

目的：观察无痛胃镜在老年食管静脉曲张治疗中的疗效。方法选取2011年8月至2012年8月成都市公共卫生临床医疗中心急诊科收治的行食管静脉曲张套扎的老年食管静脉曲张患者136例，采用随机数字表法分为无痛胃镜组88例和常规胃镜组48例，观察两组患者术前、术中和术后的心率、血压、呼吸、血氧饱和度指标变化、不良反应、出血情况、耐受程度及术前、术后7d的肝功能情况。结果无痛胃镜组术前心率快于术中[（77．4±16．3）次／min vs （75．6±16．7）次／min]，术前收缩压、舒张压高于术中[（192．1±16．6）mmHg vs （105．6±16．2） mmHg；（75．8±8．8） mmHg vs （63．7±9．3） mmHg]（P＜0．05）；常规胃镜组术前心率慢于术中[（80．0±16．0）次／min vs （82．1±15．7）次／min]，术前收缩压、舒张压低于术中[（117．4±20．4） mmHg vs （131．0±16．7） mmHg；（67．0±12．5）mmHg vs （73．0±9．0） mmHg]（P＜0．05）；无痛胃镜组满意度55．68％，显著高于常规胃镜组的18．75％（P＜0．05）。结论无痛胃镜在老年食管静脉曲张治疗中具有治疗效果好、安全性高、镜下视野清、不良反应少、患者痛苦小等优势，值得临床进一步推广和研究。
목적：관찰무통위경재노년식관정맥곡장치료중적료효。방법선취2011년8월지2012년8월성도시공공위생림상의료중심급진과수치적행식관정맥곡장투찰적노년식관정맥곡장환자136례，채용수궤수자표법분위무통위경조88례화상규위경조48례，관찰량조환자술전、술중화술후적심솔、혈압、호흡、혈양포화도지표변화、불량반응、출혈정황、내수정도급술전、술후7d적간공능정황。결과무통위경조술전심솔쾌우술중[（77．4±16．3）차／min vs （75．6±16．7）차／min]，술전수축압、서장압고우술중[（192．1±16．6）mmHg vs （105．6±16．2） mmHg；（75．8±8．8） mmHg vs （63．7±9．3） mmHg]（P＜0．05）；상규위경조술전심솔만우술중[（80．0±16．0）차／min vs （82．1±15．7）차／min]，술전수축압、서장압저우술중[（117．4±20．4） mmHg vs （131．0±16．7） mmHg；（67．0±12．5）mmHg vs （73．0±9．0） mmHg]（P＜0．05）；무통위경조만의도55．68％，현저고우상규위경조적18．75％（P＜0．05）。결론무통위경재노년식관정맥곡장치료중구유치료효과호、안전성고、경하시야청、불량반응소、환자통고소등우세，치득림상진일보추엄화연구。
Objective To observe curative effect of painless gastroscopy in the treatment for elderly esophageal varices.Methods A total of 136 cases of elderly patients with esophageal varices treated with endoscopic variceal ligation in Chengdu Public Health Clinical Center from Aug .2011 to Aug.2012 August were randomly divided into painless gastroscopy group ( 88 cases ) and conventional gastroscope group ( 48 cases).The preoperative,intraoperative and postoperative heart rate,blood pressure,respiratory,blood oxy-gen saturation index changes,adverse reactions,bleeding,pain tolerance,and the liver function before opera-tion and 7 days after operation of the two groups were observed.Results In the painless gastroscope group, the preoperative heart rate was significantly faster than those of intraoperation[(77.4 ±16.3) beat/min vs (75.6 ±16.7) beat/min],preoperative systolic pressure and diastolic pressure was significantly higher than that intraoperation[(192.1 ±16.6)mmHg vs (105.6 ±16.2) mmHg;(75.8 ±8.8)mmHg vs (63.7 ± 9.3) mmHg](P<0.05).In the conventional gastroscopy group,the preoperative heart rate was lower than that of intraoperation[(80.0 ±16.0) beat/min vs (82.1 ±15.7) beat/min],the preoperative systolic pres-sure and diastolic pressure was lower than that of intraoperation[(117.4 ±20.4) mmHg vs (131.0 ±16.7) mmHg;(67.0 ±12.5)mmHg vs (73.0 ±9.0) mmHg](P <0.05).Satisfaction degree of painless gastros-copy group was significantly higher than that of conventional endoscopy group(55.68% vs 18.75%)(P<0.05).Conclusion Painless gastroscopy in the treatment for elderly esophageal varices has the advantages of good curative effect,high safety,clear microscopic vision,less adverse reaction and less pain,therefore,it is worth of further promotion and research .